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General NPI Number Information
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NPI Number | 1104015668
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Entity Type | Individual
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Provider Name | ERIN MARTIN LPC
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Gender | Female
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Dates
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Enumeration Date | 10/22/2007
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Last Update Date | 09/23/2024
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Provider Practice Location Address
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Address Line | 5920 S BELLVIEW RD
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City | ROGERS
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State | AR
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Zip | 72758-9024
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Country | US
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Telephone | 479-644-3078
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Fax |
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Provider Business Mailing Address
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Address Line | 4614 WILLOW RIDGE WAY
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City | ROGERS
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State | AR
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Zip | 72758-8089
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Country | US
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Telephone | 501-622-7682
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Fax | 479-521-6520
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | P1505051
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License Number State | AR
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